Optimizing Preoperative Assessments

From Rules to Decisions. From Decisions to Value.

Presented by

Dr. John Svribely, CMIO at Trisotech

Denis Gagne, CEO & CTO at Trisotech

A patient undergoing surgery may have to undergo many preoperative assessments, which are often manual and time-consuming. Preauthorization has become synonymous with endless forms and delays and with the occasional denial of care that the provider had deemed appropriate. A payer organization must balance quality of care, reimbursement and patient satisfaction, while being compliant with ever changing rules and regulations.

In an era of digital transformation, it is possible to completely automate low-risk preauthorizations. This can be done using processes and decisions using visual low-code models that are easily changed to meet changing requirements. The same models can be used to risk stratify patients, to prepare dashboards to quickly visualize data and to prepare data for predictive analytics (AI). Automated BPM+ visual models can help to achieve these goals, with SmileCDR providing and collecting the standardized data.

In this session, we will introduce and demonstrate visual modeling and automation for preauthorization based on a set of international open standards called BPM+. We will show how changes to compliance rules can be rapidly and easily traced to modify automation services accordingly, using an example in orthopedic surgery.

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